DR. MICHELLE WALLACE M.D.
NPI 1316111719
Pediatrics - Pediatric Cardiology in Stockbridge, GA
NPI Status: Active since April 16, 2008
Contact Information
202 VILLAGE CENTER PKWY
STOCKBRIDGE, GA
ZIP 30281
Phone: (404) 256-2593
- Individual
- Female
- Years of Experience 22
- Pediatrics
- Pediatric Cardiology
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
About MICHELLE WALLACE
This page provides the complete NPI Profile along with additional information for Michelle Wallace, a pediatrician established in Stockbridge, Georgia with a medical specialization in Pediatrics, focusing in pediatric cardiology and more than 22 years of experience. She graduated from Morehouse School Of Medicine in 2004. The healthcare provider is registered in the NPI registry with number 1316111719 assigned on April 2008. The practitioner's primary taxonomy code is 2080P0202X with license number 064090 (GA). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1316111719
- Provider Name
- DR. MICHELLE WALLACE M.D.
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 202 VILLAGE CENTER PKWY STOCKBRIDGE, GA 30281
- Location Phone
- (404) 256-2593
- Mailing Address
- 2835 BRANDYWINE RD SUITE 300 ATLANTA, GA 30341
- Medical School Name
- MOREHOUSE SCHOOL OF MEDICINE
- Graduation Year
- 2004
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-16-2008
- Last Update Date
- 01-25-2021
- Code Navigator
A pediatrician like Michelle Wallace is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pediatrics Pediatric Cardiology
- Taxonomy Code
- 2080P0202X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 064090
- License State
- GA
- Taxonomy Description
- A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | 141727 (NC) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- SoloCare Bronze EPO HDHP 8050 10004 - EPO
- SoloCare Exp Bronze EPO 7200 - $0 Generic Rx 10015 - EPO
- SoloCare Gold EPO 2300 - 3 Free PCP Visits, $5 Generic Rx 10010 - EPO
- SoloCare Silver EPO 6000/60 - 3 Free PCP Visits 10014 - EPO
- SoloCare Silver EPO 7000 - 3 Free PCP Visits, $5 Generic Rx 10013 - EPO
- SoloCare Standard Exp Bronze EPO 10008 - EPO
- SoloCare Standard Gold EPO 10006 - EPO
- SoloCare Standard Platinum EPO 10005 - EPO
- SoloCare Standard Silver EPO 10007 - EPO
- Clear Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Clear Silver with $0 Insulin Options - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Gold with Atrium Health - HMO
- Complete Gold with Atrium Health + Vision + Adult Dental - HMO
- Complete Silver with Atrium Health - HMO
- Complete Silver with Atrium Health + Vision + Adult Dental - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Bronze with Atrium Health - HMO
- Clear Silver - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options - EPO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Standard Expanded Bronze WellCare - PPO
- Standard Gold WellCare - PPO
- Standard Silver WellCare - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Michelle Wallace is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Michelle Wallace is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 7517154123
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20101208001110
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Reviews for DR. MICHELLE WALLACE M.D.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 1 | 6 | 1 | 1 | 1 | 7 | 1 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 2 | 6 | 2 | 1 | 2 | 7 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 2 + 6 + 2 + 1 + 2 + 7 + 2 + 24 = 51 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 51 = 9 | 9 | ||||||||
The NPI number 1316111719 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 2 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1124159751 | DR. MATTHEW EDWARD OSTER MD Individual | Pediatrics (Pediatric Cardiology) | 202 VILLAGE CENTER PKWY STOCKBRIDGE, GA 30281 (404) 256-2593 |
| 1073759379 | RONALD ALLEN LIGON JR. M.D. Individual | Pediatrics (Pediatric Cardiology) | 202 VILLAGE CENTER PKWY STOCKBRIDGE, GA 30281 (404) 256-2593 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1316111719, enumerated in the NPI registry as an "individual" on April 16, 2008
The provider is located at 202 Village Center Pkwy Stockbridge, Ga 30281 and the phone number is (404) 256-2593
The provider's speciality is Pediatrics with taxonomy code 2080P0202X with a focus in Pediatric Cardiology
The provider has more than 22 years of experience. She graduated from Morehouse School Of Medicine in 2004.
The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
This NPI record was last updated on April 16, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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